<form name="form1" method="post" action="">
    <div class="login-form">
        <h1>Login to Cpanel</h1>
        <ul class="login-ul">
            <li>Username</li>
            <li><input type="text" name="name" class="login-username" /></li>
            <li>Password</li>
            <li><input type="password" name="pass" class="login-password" /></li>
            <li><input type="submit" class="login-button" name="btnLogin" id="btnLogin" value="Login" /></li>
            <li><a href="../index.php" title="Back to Home">&laquo; Back to Home</a></li>
        </ul>
    </div>
</form>